【摘要】 目的研究高频rTMS辅助盐酸齐拉西酮片治疗老年精神分裂症的临床效果。方法选取2015年6月～2018年8月我院老年精神分裂症患者89例,按随机数字表法分联合组(n=45)、药物组(n=44)。药物组予以盐酸齐拉西酮片治疗,联合组予以盐酸齐拉西酮片、高频rTMS联合治疗。对比两组疗效、不良反应、治疗前及治疗2个月后症状情况(阳性症状评分、阴性症状评分)、血清胶质纤维酸性蛋白(GFAP)、脑源性神经营养因子(BDNF)、神经生长因子(NGF)水平。结果 (1)疗效:联合组总有效率为93.33%(42/45),较药物组77.27%(34/44)高(P<0.05);(2)症状情况:治疗2个月后两组阳性症状、阴性症状评分显著改善,且联合组低于药物组(P<0.05);(3)血清GFAP、BDNF、NGF水平:治疗2个月后联合组血清GFAP水平低于药物组,血清BDNF、NGF水平高于药物组(P<0.05);(4)不良反应:不良反应均为轻度,未影响治疗;联合组不良反应发生率2.22%(1/45)与药物组4.55%(2/44)对比,差异无统计学意义(P>0.05)。结论盐酸齐拉西酮片联合高频rTMS对血清因子有显著调节作用,能进一步提高老年精神分裂症的疗效,且不良反应发生率低,安全性高。更多还原

【Abstract】 Objective To study the clinical effect of high frequency rTMS assistants ziprasidone hydrochloride tablets in the treatment of senile severe schizophrenia. Methods From June 2015 to August 2018,89 patients with severe schizophrenia in our hospital were enrolled. The patients were divided into two groups according to the random number table. The drug group was treated with ziprasidone hydrochloride tablets(n=45),and the combination group was treated with ziprasidone hydrochloride tablets and high frequency rTMS(n=44). The efficacy,adverse reactions,symptoms before treatment and 2 months after treatment(positive symptom score,negative symptom score),serum glial fibrillary acidic protein(GFAP),brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF)level were compared between these two groups. Results (1)Efficacy :The total effective rate was 93.33%(42/45)in the combination group,which was higher than 77.27%(34/44)in the drug group(P<0.05).(2)Symptoms :2 months after treatment,positive and negative symptom scores were significantly improved,and the combination group was lower than the drug group(P<0.05).(3)Serum GFAP,BDNF,NGF levels :serum GFAP levels in the combined group were lower than those in the drug group after 2 months of treatment,serum BDNF The level of NGF was higher than that of the drug group(P<0.05).(4)Adverse reactions :all adverse reactions were mild and did not affect treatment;the incidence of adverse reactions in the combined group was 2.22%(1/45)and 4.55% in the drug group(2/44)Contrast,the difference was not statistically significant(P>0.05). Conclusion Ziprasidone hydrochloride tablets combined with high-frequency rTMS have a significant regulatory effect on serum factors,which can further improve the efficacy of severe schizophrenia in the elderly with low incidence of adverse reactions and high safety.更多还原